Inside One Abortion Clinic, Signs of Nationwide Struggles

FORT MYERS, Fla. — At a Planned Parenthood health center on Florida’s Gulf Coast, new restrictions on who can get an abortion are shaking up routines and creating challenges for the clinic’s patients, doctors and nurses.

The center, in Fort Myers, has seen a steady influx of patients from Texas since last September, when a ban on all but the earliest abortions took effect there, and from other states that have tightened access to the procedure over the past year.

It is also adjusting to a waiting period that took effect in Florida in April after years of litigation, requiring patients seeking an abortion to have an ultrasound and then wait at least 24 hours before returning for the actual procedure. And a new state law banning most abortions after 15 weeks of pregnancy, instead of the current 24 weeks, is set to take effect on July 1, although Planned Parenthood and other abortion providers in the state have sued to try to block it.

On top of those changes, the Supreme Court is poised to issue a ruling that could overturn Roe v. Wade, the 1973 decision legalizing abortion throughout the United States. Florida is not among the 13 states with so-called trigger laws, which will quickly ban nearly all abortions if Roe is overturned. But several nearby states have such laws, so the center could end up seeing even more visitors from out of state after the ruling. And the Florida Legislature could enact more restrictions.

Many patients in Florida get medication abortions, which involve taking two different drugs, 24 to 48 hours apart, and are authorized for the first 10 weeks of pregnancy. But the center provides surgical abortions up until almost 22 weeks of pregnancy, too — at least until the new law takes effect. It also provides pelvic and breast exams, different types of contraception, testing and treatment for sexually transmitted diseases, and other types of reproductive health care.

Protesters are a near-constant presence at the center. Planned Parenthood moved to a new, larger building in 2020; one morning in January, several dozen protesters blocked the entrance, leading to at least nine arrests. Staff members working that day feared the building itself would be breached, but they hit a panic button that locked the doors, and the police arrived quickly, said Stephanie Fraim, the president and chief executive of Planned Parenthood of Southwest and Central Florida.

One afternoon in May, a 72-year-old former nurse was among a group of Catholic protesters gathered outside the center, praying that people would not choose the procedure. “Abortion is not health care,” said the retired nurse, who asked to be identified only by her first name, Gwen. “Murder on either end of your life is not health care.”

The next day, a 27-year-old mother of two was waiting for her surgical abortion to begin. She had wanted to continue with her pregnancy, she said. But as she and her fiancé agonized over how they could afford life with a third child, she had decided against it. Her fiancé had considered taking a second job, but she wanted him to have time to spend with their daughters.

Once the procedure got underway, Dr. Stacy De-Lin, then the center’s associate medical director, worked quickly as the patient cried softly on the exam table, her fiancé squeezing her hand. A few minutes later, when the abortion was finished, the couple embraced at length. She had been 11 weeks pregnant.

“It was heavy on me,” the patient said later, reflecting on the experience. “It was not something I wanted to do. But it was something we needed to do as a couple, that would benefit our family and our children.”

Dr. De-Lin moved back to New York City last month. She had previously worked as the associate medical director of Planned Parenthood of Greater New York and would once again practice in the state, where abortion will remain legal for up to 24 weeks of pregnancy, or later if the fetus is not viable or the patient’s life or health is at risk, regardless of how the Supreme Court rules. Part of the reason she left Florida, she said, was that she would no longer be allowed to perform abortions past 15 weeks of pregnancy if the new law took effect as planned.

“The state you live in shouldn’t dictate the health care you’re able to access,” she said, “so it just feels enormously overwhelming and heartbreaking.”

Gabriela Bhaskar reported from Fort Myers, and Abby Goodnough from Washington.